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Abdominoplasty approval

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dkeyez@... writes

<<i need some advice on getting my tummy tuck approved.>>

My advice: never call it a tummy tuck - it is reconstructive surgery,

specifically an abdominoplasty. Kind of gets you in the right mind set.

For my carriers (Cigna for me, HealthNet for hubby), the key was having a

thorough record of the associated medical issues and what we had done to try to

resolve them. Go to the doctor every month to talk about the lower back pain

the pannus is undoubtedly causing. If you have rashes, go every month and get a

prescription. In my case, I tried pain medication, physical therapy, and a

personal trainer at the gym to strengthen musculature to try and support the

pannus. All the efforts were documented; obviously, all of them failed. Hubby

has done the same since about 1 year post-op with trips to the dr to document.

In my case, I had to go through 3 appeals for approval. In his case, we just

got his approval the first go-round, no questions asked. It does help to have a

surgeon who will phrase their request appropriately as well, stressing the

reconstructive nature of the surgery.

Kate

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dkeyez@... writes

<<i need some advice on getting my tummy tuck approved.>>

My advice: never call it a tummy tuck - it is reconstructive surgery,

specifically an abdominoplasty. Kind of gets you in the right mind set.

For my carriers (Cigna for me, HealthNet for hubby), the key was having a

thorough record of the associated medical issues and what we had done to try to

resolve them. Go to the doctor every month to talk about the lower back pain

the pannus is undoubtedly causing. If you have rashes, go every month and get a

prescription. In my case, I tried pain medication, physical therapy, and a

personal trainer at the gym to strengthen musculature to try and support the

pannus. All the efforts were documented; obviously, all of them failed. Hubby

has done the same since about 1 year post-op with trips to the dr to document.

In my case, I had to go through 3 appeals for approval. In his case, we just

got his approval the first go-round, no questions asked. It does help to have a

surgeon who will phrase their request appropriately as well, stressing the

reconstructive nature of the surgery.

Kate

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